Keith Miller briskly walks down a bare, white hallway, through swinging doors and into what could be a emergency room movie set.

Here, he said, patients would be operated on if there were a bottleneck in the actual operating room caused by too many patients – like in the case of a mass shooting like what happened in Las Vegas this week.

“The types of injuries you’re talking about responding to in a mass casualty event are the types of injuries we see here every day, it’s just that there are substantially more of them,” said Miller, a trauma surgeon at University of Louisville Hospital. “So when it comes to preparing for something like this, it’s always in the back of your head.”

Not only is University of Louisville Hospital the only Level 1 adult trauma center in Louisville—it’s the only Level 1 trauma center in a 70-county area spreading south into Kentucky and north into Indiana. The “Level 1” designation indicates the facility is capable of providing the highest level of surgical care for trauma patients, and University of Louisville Hospital is staffed 24/7 to deal with traumatic injuries–everything from car accidents to workplace explosions.

And in the event there’s a mass shooting or any large-scale disaster in the region, this sterile space would quickly be filled with patients, and extend into a nearby hallway and other areas.

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